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False Medical History Defeats No Fault Claim\n\nThis case arose out of an accident that occurred in 2019. Plaintiff was \nhit by a car at around 8:15 p.m. while riding a bicycle in Flint, \nMichigan. Plaintiff sustained serious injuries, including multiple \nbroken bones and lacerations, blunt force trauma to the chest and \nabdomen, and a traumatic brain injury. However he submitted a claim with\n false representations about his past medical history and his suit was \ndismissed.\n\nRonnie Fields appealed the trial court's order granting summary \ndisposition to defendant, Nationwide Mutual Fire Insurance Company. In \nRonnie Fields and Anderson Medical Supplies v. National General \nInsurance Company, Integon National Insurance Company, Garlando Doxie, \nKanesha Marzette, and Michigan Automobile Insurance, Defendants, and \nNationwide Mutual Fire Insurance Company, No. 361959, Court of Appeals \nof Michigan (August 17, 2023) the Court of Appeals gave effect to the \nallegations of fraud.\n\nFACTUAL BACKGROUND\n\nIn relation to the accident, plaintiff submitted two applications for \npersonal protection insurance (PIP) benefits through the Michigan \nAutomobile Insurance Placement Facility (MAIPF). The applications stated\n that plaintiff did not have any of the same injuries prior to the \naccident, that he had no preexisting medical conditions, and that he had\n not applied for social security benefits before or after the accident.\xa0\n However, his second application noted that plaintiff was eligible for \nsocial security benefits, contrary to the information from the October \n4, 2019 application. Each of the applications contained a fraud warning.\n\nPlaintiff sued in February 2020 the MAIPF was required to assign his \nclaim to an insurer. N\n\nThe trial court entered an order granting Nationwide's motion for \nsummary disposition.\n\nFRAUD\n\nA person commits a fraudulent insurance act when: (1) the person \npresents or causes to be presented an oral or written statement, (2) the\n statement is part of or in support of a claim for no-fault benefits, \nand (3) the claim for benefits was submitted to the MAIPF. Further, (4) \nthe person must have known that the statement contained false \ninformation, and (5) the statement concerned a fact or thing material to\n the claim.\n\nTHE LIES\n\nFinding no dispute that the two applications for benefits erroneously \nindicated that plaintiff had no preexisting medical conditions and had \nnot sustained any prior injuries that might be relevant to his claim for\n benefits. \n\nANALYSIS\n\nPlaintiff's medical records could be considered as evidence of fraud \neven though the medical records were obtained by Nationwide during \ndiscovery, the information contained in them concerned incidents that \noccurred well before plaintiff applied for PIP benefits through the \nMAIPF. \n\nPlaintiff signed the applications, suggesting that they must be \nconsidered his own. He argued that it is unclear whether he knew what he\n was signing, as he was legally blind at the time and would have needed \nsomeone to read the document to him.\n\nMoreover, since plaintiff signed the applications-particularly the \nNovember 4, 2019 application-and has provided no evidentiary proof to \nsupport the argument that he lacked the capacity to do so, that he did \nso by mistake, or that he was coerced or defrauded in this case, the \ntrial court's ruling was affirmed.\n\nZALMA OPINION\n\nEven no-fault insurance statutes remove the right to benefits if the \nperson seeking the benefits commits fraud in seeking the benefits. There\n is no question that the Plaintiff filed two applications for benefits \nthat contained false statements. As a result, even though he was \nseriously injured, his fraudulent statements defeated his claim, proving\n that liars in Michigan will never prosper from the no-fault system.\n\n(c) 2023 Barry Zalma & ClaimSchool, Inc.\n